tbuckley/cabot-search huggingface dataset:
Deficits and Disparities in Early Uptake of Glucagon-Like Peptide 1 Receptor Agonists and SGLT2i Among Medicare-Insured Adults Following a New Diagnosis of Cardiovascular Disease or Heart Failure
Authors: Sara J. Cromer, Julie C. Lauffenburger, Raisa Levin, Elisabetta Patorno
Journal: Diabetes Care (2022)

OBJECTIVE To examine the association of race/ethnicity and socioeconomic deprivation with initiation of guideline-recommended diabetes medications with cardiovascular benefit (glucagon-like peptide 1 receptor agonists [GLP1-RA] and sodium–glucose cotransporter 2 inhibitors [SGLT2i]) among older adults with type 2 diabetes (T2D) and either incident atherosclerotic cardiovascular disease (ASCVD) or congestive heart failure (CHF). RESEARCH DESIGN AND METHODS Using Medicare data (2016–2019), we identified 4,057,725 individuals age &amp;gt;65 years with T2D and either incident ASCVD or CHF. We estimated incidence rates and hazard ratios (HR) of GLP1-RA or SGLT2i initiation within 180 days by race/ethnicity and zip code–level Social Deprivation Index (SDI) using adjusted Cox proportional hazards models. RESULTS Incidence rates of GLP1-RA or SGLT2i initiation increased over time but remained low (&amp;lt;0.6 initiations per 100 person-months) in all years studied. Medication initiation was less common among those of Black or other race/ethnicity (HR 0.81 [95% CI 0.79–0.84] and HR 0.84 [95% CI 0.75–0.95], respectively) and decreased with increasing SDI (HR 0.96 [95% CI 0.96–0.97]). Initiation was higher in ASCVD than CHF (0.35 vs. 0.135 initiations per 100 person-months). Moderate (e.g., nephropathy, nonalcoholic fatty liver disease) but not severe (e.g., advanced chronic kidney disease, cirrhosis) comorbidities were associated with higher probability of medication initiation. CONCLUSIONS Among older adults with T2D and either ASCVD or CHF, initiation of GLP1-RA or SGLT2i was low, suggesting a substantial deficit in delivery of guideline-recommended care or treatment barriers. Individuals of Black and other race/ethnicity and those with higher area-level socioeconomic deprivation were less likely to initiate these medications.
Trajectories of Cognition and Daily Functioning Before and After Incident Diabetes
Authors: Xiaoli Ji, Hui Gao, Daoyuan Sun, Jianlin Zhuang, Yuan Fang, Kan Wang, Fariba Ahmadizar
Journal: Diabetes Care (2022)

The temporal pattern of cognitive and functional change before and after incident diabetes remains unknown.Data from wave 2 to wave 9 (2004-2018) of the English Longitudinal Study of Ageing were used. Global cognition (assessed by orientation, memory, and executive function) and daily functioning (calculated as the sum of impaired basic and instrumental activities of daily living) were measured in each wave. Incident diabetes was defined as glycated hemoglobin A1c ≥6.5% (47.5 mmol/mol), self-reported doctor diagnosis of diabetes, or glucose-lowering medication use during follow-up.Among the 6,342 participants (mean age 65.0 years, 57.8% women) included, 576 participants (9.1%) with incident diabetes were identified during a median follow-up of 13.3 years. The annual rates of change in global cognition (β = -0.035 SD/year; 95% CI -0.054 to -0.015), orientation (-0.031 SD/year; -0.060 to -0.002), memory (-0.016 SD/year; -0.029 to -0.003), and executive function (-0.027 SD/year; -0.042 to -0.013) were accelerated after diabetes diagnosis compared with before the event. The postdiabetes annual changes in daily functioning (0.093 points/year; 95% CI 0.056-0.131) were also accelerated compared with the prediabetes diagnosis. However, the rate of cognitive and functional decline before the diabetes diagnosis in participants with future incident diabetes was similar to the rate in participants without diabetes. Also, no significant acute change was observed during its onset.Incident diabetes is associated with accelerated cognitive and functional decline after, but not before, the event. We suggest careful monitoring for cognitive and physical dysfunction after a diabetes diagnosis.
Knowledge of Genome Sequencing and Trust in Medical Researchers Among Patients of Different Racial and Ethnic Groups With Idiopathic Dilated Cardiomyopathy
Authors: Hanyu Ni, Elizabeth Jordan, Jinwen Cao, Daniel D. Kinnamon, Stephen S. Gottlieb, Mark Hofmeyer, Javier Jimenez, Daniel P. Judge, Evan Kransdorf, Alanna A. Morris, Anjali Owens, Palak Shah, W. H. Wilson Tang, Jessica Wang, Ray E. Hershberger
Journal: JAMA Cardiology (2022)

Cardiovascular disease contributes outsized mortality in patients from underrepresented racial and ethnic groups. Understanding levels of trust in medical researchers and knowledge of genome sequencing may help identify barriers to research participation and develop strategies to educate patients about the role of genetics in cardiovascular disease.To assess racial and ethnic differences in trust in medical researchers and genome-sequencing knowledge among patients with idiopathic dilated cardiomyopathy and determine the association between trust in medical researchers and genome-sequencing knowledge.This cross-sectional study conducted by a consortium of 25 US heart failure programs included patients with idiopathic dilated cardiomyopathy defined as left ventricular systolic dysfunction and left ventricular enlargement after excluding usual clinical causes. Enrollment occurred from June 7, 2016, to March 15, 2020.Percent distributions, means, and associations of genome-sequencing knowledge scores and research trust scores for Hispanic, non-Hispanic Black (hereafter referred to as Black), and non-Hispanic White participants (hereafter referred to as White).Among 1121 participants, mean (SD) age was 51.6 (13.6) years with 41.4% Black, 8.5% Hispanic, and 43.4% female. After accounting for site effects, the level of genome-sequencing knowledge was lower in Hispanic and Black participants compared with White participants (mean score difference, -2.6; 95% CI, -3.9 to -1.2 and mean score difference, -2.9; 95% CI, -3.6 to -2.2, respectively). The level of trust in researchers was lowest in Black participants (mean score, 27.7), followed by Hispanic participants (mean score, 29.4) and White participants (mean score, 33.9). Racial and ethnic differences remained after adjusting for education, age at enrollment, duration of dilated cardiomyopathy, and health status. A higher level of trust was associated with a higher level of genome-sequencing knowledge within different racial and ethnic groups.In this cross-sectional study, large racial and ethnic differences in levels of genome-sequencing knowledge and trust in medical researchers were observed among patients with dilated cardiomyopathy. Findings from this study can inform future studies that aim to enhance the uptake of genomic knowledge and level of trust in medical researchers.
Using national electronic health records for pandemic preparedness: validation of a parsimonious model for predicting excess deaths among those with COVID-19–a data-driven retrospective cohort study
Authors: Mehrdad A Mizani, Ashkan Dashtban, Laura Pasea, Alvina G Lai, Johan Thygesen, Chris Tomlinson, Alex Handy, Jil B Mamza, Tamsin Morris, Sara Khalid, Francesco Zaccardi, Mary Joan Macleod, Fatemeh Torabi, Dexter Canoy, Ashley Akbari, Colin Berry, Thomas Bolton, John Nolan, Kamlesh Khunti, Spiros Denaxas, Harry Hemingway, Cathie Sudlow, Amitava Banerjee
Journal: Journal of the Royal Society of Medicine (2022)

Objectives To use national, pre- and post-pandemic electronic health records (EHR) to develop and validate a scenario-based model incorporating baseline mortality risk, infection rate (IR) and relative risk (RR) of death for prediction of excess deaths. Design An EHR-based, retrospective cohort study. Setting Linked EHR in Clinical Practice Research Datalink (CPRD); and linked EHR and COVID-19 data in England provided in NHS Digital Trusted Research Environment (TRE). Participants In the development (CPRD) and validation (TRE) cohorts, we included 3.8 million and 35.1 million individuals aged ≥30 years, respectively. Main outcome measures One-year all-cause excess deaths related to COVID-19 from March 2020 to March 2021. Results From 1 March 2020 to 1 March 2021, there were 127,020 observed excess deaths. Observed RR was 4.34% (95% CI, 4.31–4.38) and IR was 6.27% (95% CI, 6.26–6.28). In the validation cohort, predicted one-year excess deaths were 100,338 compared with the observed 127,020 deaths with a ratio of predicted to observed excess deaths of 0.79. Conclusions We show that a simple, parsimonious model incorporating baseline mortality risk, one-year IR and RR of the pandemic can be used for scenario-based prediction of excess deaths in the early stages of a pandemic. Our analyses show that EHR could inform pandemic planning and surveillance, despite limited use in emergency preparedness to date. Although infection dynamics are important in the prediction of mortality, future models should take greater account of underlying conditions.
In Vitro Efficacy of Antiviral Agents against Omicron Subvariant BA.4.6
Authors: Emi Takashita, Seiya Yamayoshi, Peter Halfmann, Nancy Wilson, Hunter Ries, Alex Richardson, Max Bobholz, William Vuyk, Robert Maddox, David A Baker, Thomas C Friedrich, David H O'Connor, Ryuta Uraki, Mutsumi Ito, Yuko Sakai-Tagawa, Eisuke Adachi, Makoto Saito, Michiko Koga, Takeya Tsutsumi, Kiyoko Iwatsuki-Horimoto, Maki Kiso, Hiroshi Yotsuyanagi, Shinji Watanabe, Hideki Hasegawa, Masaki Imai, Yoshihiro Kawaoka
Journal: New England Journal of Medicine (2022)
High Diagnostic Accuracy of Epigenetic Imprinting Biomarkers in Thyroid Nodules
Authors: Huixiong Xu, Yifeng Zhang, Hongxun Wu, Ning Zhou, Xing Li, John P. Pineda, Yun Zhu, Huijun Fu, Ming Ying, Shufang Yang, Jiandong Bao, Lulu Yang, Bingjie Zhang, Lehang Guo, Liping Sun, Feng Lu, Hanxiang Wang, Ying Huang, Tiantong Zhu, Xiaonan Wang, Qing Wei, Chunjun Sheng, Shen Qu, Zhongwei Lv, Dong Xu, Qian Li, Yongling Dong, Jianwu Qin, Tong Cheng, Mingzhao Xing
Journal: Journal of Clinical Oncology (2022)

To explore the novel diagnostic value of epigenetic imprinting biomarkers in thyroid nodules.A total of 550 patients with fine-needle aspiration (FNA)-evaluated and histopathologically confirmed thyroid nodules were consecutively recruited from eight medical centers. Quantitative chromogenic imprinted gene in situ hybridization (QCIGISH) was used to assess the allelic expression of imprinted genes SNRPN and HM13, on the basis of which a diagnostic grading model for thyroid nodules was developed. The model was retrospectively trained on 124 postsurgical thyroid samples, optimized on 32 presurgical FNA samples, and prospectively validated on 394 presurgical FNA samples. Blinded central review-based cytopathologic and histopathologic diagnoses were used as the reference standard.For thyroid malignancy, the QCIGISH test achieved an overall diagnostic sensitivity of 100% (277/277), a specificity of 91.5% (107/117; 95% CI, 86.4 to 96.5), a positive predictive value (PPV) of 96.5% (95% CI, 94.4 to 98.6), and a negative predictive value (NPV) of 100% in the prospective validation, with a diagnostic accuracy of 97.5% (384/394; 95% CI, 95.9 to 99.0). QCIGISH demonstrated a PPV of 97.8% (95% CI, 94.7 to 100) and NPV of 100%, with a diagnostic accuracy of 98.2% (111/113; 95% CI, 95.8 to 100), for indeterminate Bethesda III-V thyroid nodules. QCIGISH demonstrated a PPV of 96.6% (95% CI, 91.9 to 100) and a NPV of 100%, with a diagnostic accuracy of 97.5% (79/81; 95% CI, 94.2 to 100), for Bethesda III-IV. For Bethesda VI, QCIGISH showed a 100% (184/184) accuracy.This imprinting biomarker-based test can effectively distinguish malignant from benign thyroid nodules. The high PPV and NPV make the test both an excellent rule-in and rule-out diagnostic tool. With such a diagnostic performance and its technical simplicity, this novel thyroid molecular test is clinically widely applicable.
Racial Disparities in Access and Use of Diabetes Technology Among Adult Patients With Type 1 Diabetes in a U.S. Academic Medical Center
Authors: Sarah Kanbour, Marissa Jones, Mohammed S. Abusamaan, Caitlin Nass, Estelle Everett, Risa M. Wolf, Aniket Sidhaye, Nestoras Mathioudakis
Journal: Diabetes Care (2022)

Recent studies highlight racial disparities in insulin pump (PUMP) and continuous glucose monitor (CGM) use in children and adolescents with type 1 diabetes (T1D). This study explored racial disparities in diabetes technology among adult patients with T1D.This was a retrospective clinic-based cohort study of adult patients with T1D seen consecutively from April 2013 to January 2020. Race was categorized into non-Black (reference group) and Black. The primary outcomes were baseline and prevalent technology use, rates of diabetes technology discussions (CGMdiscn, PUMPdiscn), and prescribing (CGMrx, PUMPrx). Multivariable logistic regression analysis evaluated the association of technology discussions and prescribing with race, adjusting for social determinants of health and diabetes outcomes.Among 1,258 adults with T1D, baseline technology use was significantly lower for Black compared with non-Black patients (7.9% vs. 30.3% for CGM; 18.7% vs. 49.6% for PUMP), as was prevalent use (43.6% vs. 72.1% for CGM; 30.7% vs. 64.2% for PUMP). Black patients had adjusted odds ratios (aORs) of 0.51 (95% CI 0.29, 0.90) for CGMdiscn and 0.61 (95% CI 0.41, 0.93) for CGMrx. Black patients had aORs of 0.74 (95% CI 0.44, 1.25) for PUMPdiscn and 0.40 (95% CI, 0.22, 0.70) for PUMPrx. Neighborhood context, insurance, marital and employment status, and number of clinic visits were also associated with the outcomes.Significant racial disparities were observed in discussions, prescribing, and use of diabetes technology. Further research is needed to identify the causes behind these disparities and develop and evaluate strategies to reduce them.
Treatment for Patients With Multifocal Intrahepatic Cholangiocarcinoma
Authors: Fan Yu, Fangqiang Wei
Journal: JAMA Surgery (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
The Effects of Daily Prednisone and Tocilizumab on Hemoglobin A<sub>1c</sub> During the Treatment of Giant Cell Arteritis
Authors: Naomi J. Patel, Veronica Tozzo, John M. Higgins, John H. Stone
Journal: Arthritis & Rheumatology (2022)

Objective To study the longitudinal effects of both glucocorticoids and tocilizumab, an interleukin‐6 receptor inhibitor, on hemoglobin A 1c (HbA 1c ) levels during glucocorticoid tapering. Methods We analyzed patients with complete data from the Giant Cell Arteritis Clinical Research Study (GiACTA) to investigate the impact of both glycemic and nonglycemic factors on changes in HbA 1c levels over the 52‐week trial. Giant cell arteritis (GCA) patients were randomized to receive either tocilizumab or placebo in addition to glucocorticoids. We used a multivariable mixed‐effects model to evaluate associations of HbA 1c level with daily glucocorticoid dose, randomization to receive tocilizumab, and red blood cell count in patients with and those without diabetes mellitus at baseline, over 52 weeks. Results In 209 patients, the median HbA 1c level decreased by 0.50% ( P &lt; 0.01) in the group that received both tocilizumab and glucocorticoids (tocilizumab/glucocorticoid) and by 0.10% ( P &lt; 0.01) in the glucocorticoid‐only group. Randomization to tocilizumab/glucocorticoid was associated with lower HbA 1c (β = −0.209% in those without diabetes, P &lt; 0.01; β = −0.290% in those with diabetes, P = 0.23). These changes had a sizable impact on glucose tolerance classification: 42.5% of patients in the tocilizumab/glucocorticoid group improved from prediabetes status to normal, compared to only 12.5% of patients treated with glucocorticoids alone. Daily glucocorticoid dose was associated with HbA 1c level in patients with baseline diabetes (β = 0.018%/mg, P &lt; 0.01) and those without baseline diabetes (β = 0.005%/mg, P &lt; 0.01). Conclusion Tocilizumab treatment was associated with a substantial reduction in HbA 1c level, independent of glucocorticoid exposure, which may be achieved through a combination of glycemic and nonglycemic effects.
A Race-neutral Approach to the Interpretation of Lung Function Measurements
Authors: Cole Bowerman, Nirav R. Bhakta, Danny Brazzale, Brendan R. Cooper, Julie Cooper, Laura Gochicoa-Rangel, Jeffrey Haynes, David A. Kaminsky, Le Thi Tuyet Lan, Refiloe Masekela, Meredith C. McCormack, Irene Steenbruggen, Sanja Stanojevic
Journal: American Journal of Respiratory and Critical Care Medicine (2022)

Rationale: The use of self-reported race and ethnicity to interpret lung function measurements has historically assumed that the observed differences in lung function between racial and ethnic groups were because of thoracic cavity size differences relative to standing height. Very few studies have considered the influence of environmental and social determinants on pulmonary function. Consequently, the use of race and ethnicity-specific reference equations may further marginalize disadvantaged populations. Objectives: To develop a race-neutral reference equation for spirometry interpretation. Methods: National Health and Nutrition Examination Survey (NHANES) III data (n = 6,984) were reanalyzed with sitting height and the Cormic index to investigate whether body proportions were better predictors of lung function than race and ethnicity. Furthermore, the original GLI (Global Lung Function Initiative) data (n = 74,185) were reanalyzed with inverse-probability weights to create race-neutral GLI global (2022) equations. Measurements and Main Results: The inclusion of sitting height slightly improved the statistical precision of reference equations compared with using standing height alone but did not explain observed differences in spirometry between the NHANES III race and ethnic groups. GLI global (2022) equations, which do not require the selection of race and ethnicity, had a similar fit to the GLI 2012 “other” equations and wider limits of normal. Conclusions: The use of a single global spirometry equation reflects the wide range of lung function observed within and between populations. Given the inherent limitations of any reference equation, the use of GLI global equations to interpret spirometry requires careful consideration of an individual’s symptoms and medical history when used to make clinical, employment, and insurance decisions.
Cellular Cancer Immunotherapy Development and Manufacturing in the Clinic
Authors: Graeme A. Fenton, Duane A. Mitchell
Journal: Clinical Cancer Research (2022)

Abstract The transfusion of naturally derived or modified cellular therapies, referred to as adoptive cell therapy (ACT), has demonstrated clinical efficacy in the treatment of hematologic malignancies and metastatic melanoma. In addition, cellular vaccination, such as dendritic cell–based cancer vaccines, continues to be actively explored. The manufacturing of these therapies presents a considerable challenge to expanding the use of ACT as a viable treatment modality, particularly at academic production facilities. Furthermore, the expanding commercial interest in ACT presents new opportunities as well as strategic challenges for the future vision of cellular manufacturing in academic centers. Current trends in the production of ACT at tertiary care centers and prospects for improved manufacturing practices that will foster further clinical benefit are reviewed herein.
Contextualizing the Landscape of Diversity, Equity, and Inclusion in Dermatology
Authors: Ellen N. Pritchett, Andrew J. Park, Rebecca Vasquez
Journal: JAMA Dermatology (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Dermatology journal
The Climate Crisis Affects Us All
Authors: Misha Rosenbach, John S. Barbieri
Journal: JAMA Dermatology (2022)

Lukoye Atwoli; Gregory E. Erhabor; Aiah A. Gbakima; Abraham Haileamlak; Jean-Marie Kayembe Ntumba; James Kigera; Laurie Laybourn-Langton; Bob Mash; Joy Muhia; Fhumulani Mavis Mulaudzi; David Ofori-Adjei; Friday Okonofua; Arash Rashidian; Maha El-Adawy; Siaka Sidibé; Abdelmadjid Snouber; James Tumwine; Mohammad Sahar Yassien; Paul Yonga; Lilia Zakhama; Chris Zielinski
Association of Intraoperative Antibiotic Irrigation With Systemic Contact Dermatitis
Authors: Jodi Y. So, Nathalie Suzuki, Jennifer K. Chen, Silvina Pugliese, Bernice Y. Kwong, Lina Meng, Golara Honari
Journal: JAMA Dermatology (2022)

This case series describes the development of morbilliform drug eruption after breast surgery.
Monocytes: A Promising New TRAIL in Ovarian Cancer Cell Therapy
Authors: Stephanie Chow, Oliver Dorigo
Journal: Clinical Cancer Research (2022)

Summary Adoptive cell transfer of IFN-activated monocytes administered intraperitoneally to patients with platinum-resistant ovarian cancer demonstrated antitumor effects and acceptable tolerability. The exposure of monocytes to IFNα and IFNγ upregulated TRAIL, which triggered caspase 8 and direct cell-to-cell contact-dependent apoptosis of ovarian cancer cells. See related article by Green et al., p. 349
Oral PD-L1 Inhibitors Crowd into the Clinic
Journal: Cancer Discovery (2022)

The first oral PD-L1 inhibitor to enter clinical testing has been discontinued for toxicity reasons, but several other small-molecule drugs targeted at the same checkpoint molecule appear to be safe with antitumor activity demonstrated in early trials. Compared with antibodies, these oral agents could offer advantages of convenience, safety, and increased tissue penetration.